Provider Demographics
NPI:1205046943
Name:PARMA, MIMI L (OD)
Entity type:Individual
Prefix:DR
First Name:MIMI
Middle Name:L
Last Name:PARMA
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:MIMI
Other - Middle Name:M
Other - Last Name:LEE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD, OD
Mailing Address - Street 1:84 E. BROAD STREET
Mailing Address - Street 2:
Mailing Address - City:HOPEWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:08525-1820
Mailing Address - Country:US
Mailing Address - Phone:609-466-0055
Mailing Address - Fax:609-466-3329
Practice Address - Street 1:84 E BROAD ST
Practice Address - Street 2:
Practice Address - City:HOPEWELL
Practice Address - State:NJ
Practice Address - Zip Code:08525-1820
Practice Address - Country:US
Practice Address - Phone:609-466-0055
Practice Address - Fax:609-466-3329
Is Sole Proprietor?:No
Enumeration Date:2007-05-23
Last Update Date:2008-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ27OA00567900152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist